| classification | name | uses | mechanism | side effect | comment |
| hypoglycemic drugs : | |||||
| insulin | insulin used in IDDM | actions of insulin : 1-on liver :a-glycogenolysis b-(-) conversion of FA & AA > ketoacid c-(-) conversion of AA > glucose d-anabolic action I-+syn & storage of triglycerides II-+ syn & storage of glycogen 2-on muscles :a-+ syn of protein b-+ syn of glycogen 3-on adipose tissue : +syn & storage of triglycerides. | 1-hypoglycemia : a-over dose b-ommission of meals c-great physical exercise ,, it is dangerous due to permenant brain ,, *treat : if alert :conc cup of glucose ,if unconscious :subcutaneuous injection e glucagon 2-insulin allergy : local at site of injection (pain or induration or pruritis) or systemic rare (unticaria or anioedema or anaphlaxis ) treat by desensitization 3-resistance immunologic :due to formn of anti-insulin IgG antibodies , or non -immunologic due to obesity or infection or ketoacidosis so + dose of insulin to give the same effect | syn & storage in B islet cells of pancres in conjugation e Zn , *3 types of insulin :Bovine from cows (diff. In 3 AA ) 2-Porcine from pigs less antigenic than bovineas it diff in 1 AA 3-human insulin *prep acc to duration of action :1-rapidly acting 2-intermediate 3-long actiog *insulin is taken SC and never taken orally ,can be taken IM in case of diabetic coma or even IV | |
| oral hypoglycemics | *plasma binding *metabolized in liver 3-excreated in kidney , Acetohexamide >more active one | ||||
| sulphonyl urea | used in type II diabetis INDDM & dieting | 1-+ pancreas to release more insulin 2- (-) plasma glucagon 3-Glibenclamide ,Glipizide (2nd ) + no. of B islet cells so + release of insulin | 1-hypoglycemia in a-old patients b-hepatic and renal failure c-(-) plasma glucagon level d-admins of other drugs as Aspirin ,phenyl butazone ,MAO inhibitors ,some sulfa drugs (other drugs (-) hypoglycemic effect :corticosteriods ,larix ,thiazide diuretics) 2-Gastrointestinal disturbance a-skin rashes b-hepato toxicity | ||
| 1st generation | tolbutamide | ||||
| chlorpropamide | duration 70-72 hrs | ||||
| Acetohexamine | |||||
| 2nd generation | Glibenclamide | potency as tolbutamise 150times | |||
| Glipizide | |||||
| Biguanides | treat of type II diabetis alone or in combination e sulfonyl urea. | 1-(-) glucose abs from GIT 2-(-)plasma level of glucagon 3-+ uptake of glucose by cells | N.B give no hypoglycemia | ||
| phenformin | more toxic >lactic acidoses >(-) PH of blood | ||||
| metformin | 1-GIT disturbance 2- nausia | ||||